The Quantitative Hcv Rna Test Is Checked Before A Patient Starts Treatment
For each patient, the result can be described as either a “high” viral load, which is usually > 800,000 IU/L, or a “low” viral load, which is usually < 800,000 IU/L. It’s not uncommon to have a viral load in the millions. Today’s hepatitis C treatments are very effective with both high and low viral loads. An undetectable HCV viral load 10-12 weeks after hepatitis C is completed is associated with a cure.
How Do Doctors Treat The Complications Of Hepatitis C
If hepatitis C leads to cirrhosis, you should see a doctor who specializes in liver diseases. Doctors can treat the health problems related to cirrhosis with medicines, surgery, and other medical procedures. If you have cirrhosis, you have an increased chance of liver cancer. Your doctor may order an ultrasound test to check for liver cancer.
If hepatitis C leads to liver failure or liver cancer, you may need a liver transplant.
What Is Hepatitis C Anyway
Its hard to keep track of the alphabet soup of hepatitis viruses , but heres what you need to know about this one: Hepatitis C, first identified in 1989, is a viral liver infection spread via the blood that causes liver inflammation and, if left untreated, can result in serious liver damage, including cirrhosis .
What hepatitis C isnt is a virus that can be spread through casual contact like hugging or shaking hands, and it definitely isnt spread through sharing food or drinks.
In order to be infected, your blood needs to come in contact with blood that’s carrying the virus. This can occur via shared needles, unclean tattoo equipment, and sharing razors or nail clippers with an infected person theres also a slightly increased risk of transmission during sexual contact if theres a break in the skin and blood is present.
Whats more, of the estimated 2 million to 2.8 million Americans living with hepatitis C, up to half dont actually know that they have it because they have zero symptoms. Yep, the infection can be doing its damage silently for decades, which is why screening is important .
Most recently, a 2021 CDC report showed that people age 18 to 40 years saw a steady increase in new hep C cases each year since 2013, rising to 2.8 cases in every 100,000 people in 2019. The increase is credit to the opioid epidemic and an increase in drug use, including the use of shared needles.
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Are Test Results Accurate
Although no test is perfect, hepatitis C testing is an important and accepted method of testing for HCV. In order to reduce the risk of inaccurate results, doctors take steps to verify a patients diagnosis. For example, a positive test result for hepatitis C antibody requires confirmation with HCV RNA testing.
Who Is More Likely To Get Hepatitis C
People more likely to get hepatitis C are those who
- have injected drugs
- had a blood transfusion or organ transplant before July 1992
- have hemophilia and received clotting factor before 1987
- have been on kidney dialysis
- have been in contact with blood or infected needles at work
- have had tattoos or body piercings
- have worked or lived in a prison
- were born to a mother with hepatitis C
- are infected with HIV
- have had more than one sex partner in the last 6 months or have a history of sexually transmitted disease
- are men who have or had sex with men
In the United States, injecting drugs is the most common way that people get hepatitis C.13
Test Frequency And Turnaround Time
Hepatitis C Serology testing is performed daily Monday to Friday.
Turnaround time is up to 3 days from receipt by PHO laboratory for Non-reactive antibody results. Reactive and Indeterminate HCV antibody results are available and reported within 6 days.
Repeat testing may be indicated in those with ongoing risk factors for the acquisition of HCV.
Once a patient tests positive for HCV antibodies, other than in cases of maternal antibody transfer, there is no value in repeating the test as they will remain antibody positive for life regardless of whether they have cleared the virus or are chronic carriers.
How Much Does The Test Cost
The cost of hepatitis C testing depends on the tests that are performed, where the test is conducted, and a patients health insurance coverage. When testing is ordered by a doctor, patients with health insurance may find it helpful to discuss the cost of hepatitis C testing with their insurance company. In addition to the cost of testing, there may be other out-of-pocket costs such as copays and deductibles.
For patients without health insurance, or for whom insurance doesnt cover the cost of testing, it may be helpful to discuss the cost of hepatitis C testing with a doctor or hospital administrator.
At-home hepatitis C testing starts around $49. Some at-home kits test for multiple types of viral hepatitis at once, with the cost of these panels starting around $80.
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All Adults Pregnant Women And People With Risk Factors Should Get Tested For Hepatitis C
Most people who get infected with hepatitis C virus develop a chronic, or lifelong, infection. Left untreated, chronic hepatitis C can cause serious health problems, including liver damage, cirrhosis, liver cancer, and even death. People can live without symptoms or feeling sick, so testing is the only way to know if you have hepatitis C. Getting tested is important to find out if you are infected so you can get lifesaving treatment that can cure hepatitis C.
Getting Tested Is The Only Way To Know If You Have Hepatitis C
A blood test called a hepatitis C antibody test can tell if you have been infected with the hepatitis C viruseither recently or in the past. If you have a positive antibody test, another blood test is needed to tell if you are still infected or if you were infected in the past and cleared the virus on your own.
- Are 18 years of age and older
- Are pregnant
- Currently inject drugs
- Have ever injected drugs, even if it was just once or many years ago
- Have HIV
- Have abnormal liver tests or liver disease
- Are on hemodialysis
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Screening For Hcv Infection
HCV screening has several potential benefits. By detecting HCV infection early, antiviral treatment can be offered earlier in the course of the disease which is more effective than starting at a later stage. Further, early detection together with counseling and lifestyle modifications may reduce the risk of transmission of HCV infection to other people. The optimal approach to screen for HCV is to test the individuals having risk factors for exposure to the virus. The American Association for the Study of Liver Diseases recommends screening for HCV for the following individuals:
Recipient of blood or blood components .
Recipient of blood from a HCV-positive donor.
Injection drug user .
Persons with following associated conditions
persons with HIV infection,
persons who have ever been on hemodialysis, and
persons with unexplained abnormal aminotransferase levels.
Children born to HCV-infected mothers.
Healthcare workers after a needle stick injury or mucosal exposure to HCV-positive blood.
Current sexual partners of HCV-infected persons.
Do I Have The Symptoms Of Hepatitis C
Hep C usually shows up first in routine bloodwork since many people have no symptoms at all. In fact, because hep C can remain dormant for so longit takes 10 to 40 years to progress from mild disease to cirrhosis, liver failure or liver cancerthe Centers for Disease Control and Prevention is now recommending a one-time screening blood test for anyone born between 1945 and 1965 since this population is more at risk of having received a tainted blood transfusion.
In the meantime, it’s crucial to know what the symptoms of hepatitis c cirrhosis are. They include:
Taking action quickly if you have any of these symptoms is crucial. The liver, which is the second-largest organ has a big job, or rather jobs, including producing most of the protein we need, breaking down nutrients from food to produce energy, preventing nutrient shortages by storing certain vitamins, minerals and sugar, producing bile, which helps digest fat and absorb vitamins A, D, E and K, and fighting infection by removing bacteria from the blood.
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Discusses Conditions That May Cause Diagnostic Confusion Including Improper Specimen Collection And Handling Inappropriate Test Selection And Interfering Substances
A single negative hepatitis C virus RNA test result together with a reactive HCV antibody screen result with a signal-to-cutoff ratio of 8.0 or greater does not rule out the possibility of chronic HCV infection. Repeat testing for HCV RNA in 1 to 2 months is recommended in patient at risk for chronic hepatitis C.
Infants born to HCV-infected mothers may have false-reactive HCV antibody test results due to transplacental passage of maternal HCV IgG antibodies. HCV antibody testing is not recommended until at least 18 months of age in these infants.
Performance characteristics have not been established for the following types of serum specimen:
-Individuals under 10 years of age
-Presence of particulate matter
Who Is Most At Risk Of Contracting Hepatitis C
You have a high risk of contracting hepatitis C if you:
- use or have used injection drugs even if it was just once or many years ago
- have received blood or blood products or an organ transplant before July 1990 in Canada
- have been in jail or
- have been injected or scratched during vaccination, surgery, blood transfusion or a religious/ceremonial ritual in regions where hepatitis C is common.
You have a high moderate risk of contracting hepatitis C if you:
- have tattoos or body piercing
- have multiple sexual partners
- have a sexually transmitted infection , including HIV or lymphogranuloma venereum
- have experienced traumatic sex or rough sex or have used sex toys or fisting that can tear body tissue
- have vaginal sex during menstruation
- have received a kidney treatment
- have received an accidental injury from a needle or syringe
- have another infectious disease
- were born to a hepatitis C infected mother or
- have a sexual partner infected with hepatitis C.
Hepatitis C is NOT passed from person to person by:
- coughing, sneezing
- breastfeeding unless your nipples are cracked and bleeding or
- oral sex, unless blood is present.
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What The Quantitative Results Mean
The quantitative test results indicate the exact amount of HCV in your blood. This number helps your doctor confirm whether you have a high or low viral load.
Measuring your viral load before treatment allows your doctor to monitor your viral load during and after treatment.
The viral load measurement doesnt indicate how severe your HCV infection or cirrhosis is. Your doctor will need to take a biopsy, or tissue sample, from your liver to learn more about how your liver has been affected by an HCV infection.
The viral load results from the quantitative PCR test can range from 15 to 100,000,000 IU/L.
If your results are:
- Fewer than 15 IU/mL: The virus is detected, but the amount cant be measured exactly. You may need to return later for another test to see if the measurement changes.
- Fewer than 800,000 IU/mL: A low viral load is detected.
- More than 800,000 IU/mL: A high viral load is detected.
- More than 100,000,000 IU/mL: The virus is detected and active infection is taking place.
- Inconclusive: HCV RNA cant be measured, and a new sample needs to be taken.
What Is Hepatitis C
Hepatitis C is an infectious disease of the liver caused by hepatitis C virus . During the primary stage of infection, there is mild or no symptoms associated with the disease and as the disease progresses into chronic infection the symptoms become noticeable and acute symptoms are noticed in about 15%v of cases.
Hepatitis C virus infection can lead to liver disease and sometime cirrhosis, and people suffering from cirrhosis can develop complications like liver, failure, liver cancer and dilated blood vessels in the stomach and oesophagus.
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Detection Of Hepatitis C Viral Load
The Real-Time HCV assay was performed to quantify the HCV viral load in all the specimens. The assay had a linear range of 12 IU/mL to 100 million IU/mL . The Limit of Detection of this assay is 12 IU/mL , equivalent to the lower limit of quantitation . The sensitivity for the assay was 12 IU/mL for the 0.5 mL specimen volume and the specificity was 99.5%. HCV viral load1.08 log IU/mL was considered as positive.
How Serious Is It
- People can be sick for a few weeks to a few months
- Most recover with no lasting liver damage
- Although very rare, death can occur
- 15%25% of chronically infected people develop chronic liver disease, including cirrhosis, liver failure, or liver cancer
- More than 50% of people who get infected with the hepatitis C virus develop a chronic infection
- 5%-25% of people with chronic hepatitis C develop cirrhosis over 1020 years
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Getting Tested For Hepatitis C
A blood test, called an HCV antibody test, is used to find out if someone has ever been infected with the hepatitis C virus. The HCV antibody test, sometimes called the anti-HCV test, looks for antibodies to the hepatitis C virus in blood. Antibodies are chemicals released into the bloodstream when someone gets infected.
Test results can take anywhere from a few days to a few weeks to come back. Rapid anti-HCV tests are available in some health clinics and the results of these tests are available in 20 to 30 minutes.
Which Patients Should Be Screened For Hepatitis C Virus Infection
Hepatitis C virus. HCV is similar to the animal pestivirus and is close to the human Flaviviridae group. The infection is spread by contact associated with intravenous drug use and nosocomial transmission. Seventy to 80 percent of persons infected by hepatitis C are affected by chronic hepatitis, and 20 to 30 percent of these cases lead to cirrhosis with a risk of liver cancer 10 to 20 years after the initial infection. Viral diameter approximately 50-60 nm. Viral magnification 1,800,000x at 10 cm and image colorization with HDRI treatments on a transmission electron micrograph view .
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What Does A Negative Hcv Antibody Test Result Mean
A negative antibody test result usually means that the person has not been infected with hepatitis C .
The body needs at least two months to make antibodies. People with weakened immune systems are not always able to produce antibodies. This might happen in people with autoimmune disorders , HIV-positive people with a CD4 cell count below < 200 cells/mm3, and people taking immunosuppressants.
What Causes Hepatitis C In The First Place
When your blood is exposed to a hep-C infected persons blood, the virus beelines to your liver and rapidly reproduces. As this happens, the virus sends your immune system into overdrive as it works to eliminate those infected liver cells.
Over time, the way in which your immune system goes about destroying those infected cells can ultimately lead to your liver scarring, which can affect its ability to function properly.
Youre at a higher risk of getting hep C if you:
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Hcv Core Antigen Detection
During the past decade, several assays for the detection of the core antigen of HCV by ELISA or CLIA have been developed. These assays were envisioned as alternatives to NAT to be used in resource-limited settings, where molecular laboratory services are either not available or not widely utilized owing to cost issues. Since these assays are either ELISA or CLIA based, they are user friendly, require less technical expertise and are less expensive compared to molecular techniques. Evaluations in transfusion settings have shown that the HCVcore Ag assay detects HCV infection as effective as NAT, about 40-50 days earlier than the current third generation anti-HCV screening assays. HCV core antigen levels closely follow HCV RNA dynamics, and allow clinical monitoring of a patient’s therapy, independently of HCV genotype. The major limitation of the HCV core Ag assay is its lower sensitivity limiting its utility. A new generation CLIA based quantitative test with sensitivity comparable to that of end point PCR but less than that of real time RT-PCR has been reported.
Who Should Get Tested For Hepatitis C
The CDC recommends that you get tested at least once no matter what. Definitely get screened if any of these things apply to you:
- You were born between 1945 and 1965.
- You use or inject drugs.
- You have ever injected drugs — even if it was just once or a long time ago.
- Youâre on kidney dialysis.
- You have abnormal alanine aminotransferase levels .
- You had a blood transfusion, blood components, or an organ transplant before July 1992.
- Youâve ever gotten clotting factor concentrates made before 1987.
- You received blood from a donor who later tested positive for hepatitis C virus.
- Youâre a health care worker, first responder, or have another job that exposes you to HCV-infected needles.
- You were born to a mother with HCV.
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What Is The Best Treatment For Hep C
While there is currently no hep C vaccine, there are several FDA-approved prescription drugs that can cure the virus about 95% of the time. Treatment usually takes two to three months. Your healthcare provider will recommend a medication for you based on the genetic strain of the virus , the severity of your liver disease, and the presence or absence of other medical conditions such as HIV and kidney disease.
There are some people who are able to clear the virus on their own without treatment within the first six months of infection . Most of the time though, infections last longer than six months and the body needs meds to kill off the virus.